Molecular Testing in Unresectable Biliary Tract Cancer | Daniel Catenacci, MD | ASCO22 GI Updates

Dr. Daniel Catenacci, gastrointestinal cancer care expert, reviews the following case question, incorporating updates from the 2022 ASCO annual conference that have changed the standard of care.

What molecular testing is currently appropriate for metastatic or locally advanced unresectable biliary tract cancers?
A. MSI status for immunotherapy
B. BRAF mutation for anti-BRAF therapy
C. FGFR2 fusion/translocation for anti-FGFR2 therapy
D. HER2 amplification/overexpression for anti-HER2 therapy
E. IDH1 mutation for anti-IDH1 therapy
F. HER2 low expression or no expression/ISH+
G. None of the above
H. All of the above
I. All of the above except HER2 low expression or no expression/ISH+

The answer is I) all of the above, as each of these molecular subgroups have derived benefit from respective matched therapies. The question of low level HER2 expression or IHC0/ISH+ remains to be defined with larger prospective studies.

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